Non invasive assessment of large arteries structure and function is a valuable tool for early detection of athero/arteriosclerosis and the cardiovascular risk. The vascular injury is mainly represented by increased arterial stiffness (increased pulse wave velocity--PWV), increased peripheral arteries reflectivity (Aix) and the occurrence of significant atheromatosis (increased clMT). Although well described in adult, there are few data in children regarding the impact of uremia on vascular structure and function. This paper is an overview of the main determinants of arterial compliance in children, focusing on recent data describing the repercussions of hypertension and renal failure in this age group. To date, our group has performed the only case control study in children in order to describe the arterial stiffness, the reflective properties of peripheral arteries as well as the carotid intima-media thickness on 18 children under chronic dialysis treatment (hemodialysis and peritoneal dialysis). Comparing with control cases the dialysed children had a significantly higher PWV and Aix, which reinforce that uremia is associated with arterial stiffness even in children. There were no significant differences on IMT and PWV between hemodialysed and peritoneal dialysed children. In contrast with adult patient data, there was no favourable impact of hemodialysis session over PWv and Aix.